Ruth Dreifuss and Bill Richardson in The Daily Caller: “Abstinence from punishment, a path to address the opioid crisis”

By Bill Richardson, former Governor of New Mexico, and Ruth Dreifuss, former President of Switzerland and Chair of the Global Commission on Drug Policy*

More than 70’000 people died from a drug overdose in 2017 in the United States, according to reports. This sets yet a new record, emphasizing the failure of current responses to the crisis. A person is dying nearly every 7 minutes, and every community and social stratus across the country are affected.

Many elements of an effective response are well known and are being embraced by several state and local authorities. These include: awareness and prevention campaigns, the availability of opioid overdose reversal medication such as naloxone, needle and syringe programs, treatment options including opioid substitution therapy (OST), and services for social and professional reintegration.

There are, however, significant financial, administrative and ideological barriers to the efficient deployment of these services. Furthermore, these measures alone are simply not enough. There is ample evidence of the efficiency of other services and treatments such as drug checking to safeguard against impure and dangerous additives, safe injection facilities to promote safer consumption practices, and heroin-assisted treatment as a last-resort option when other responses haven’t worked, based on years of scientific monitoring in other countries.

Run by or under the strict supervision of the State, these services cannot be diverted to an illegal market or used for illegal purposes other than safe drug use. Neither have they proven to increase drug use. They do save lives, however, and contribute to ending the marginalization of people who use drugs, allowing individuals to attain, as far as possible, physical and mental health. They also help prevent reigniting HIV and hepatitis epidemics, thereby improving the overall quality and safety of communities.

These measures still encounter opposition in the US, however. This is due in part to misinformation, fear, and prejudice – but there is also a wider issue, which is generally not spoken about: the fact that our society is addicted to punishment as a means to correct what is perceived as deviant behavior. In other words, turn into a criminal offense behavior that is not aligned with a reining moral perspective, such as homosexuality and interracial marriage not so long ago.

Certainly, people’s perceptions about drug use have changed in recent years. Dependence is accepted as a disease, and people who use drugs engage in behavior that may be risky to themselves but does not directly harm others, and often do so as a result of pain or fear. But then why are drug use and possession still so heavily criminalized?

Indeed, if it was understood and accepted unequivocally that drug use presents a social and health challenge, then there should be no involvement whatsoever of the criminal justice system for use and possession for personal use. Consider drug courts, for instance. These generally entail forced treatment, not a voluntary process between patient and doctor as with other health concerns. Abstention is required to stay out of prison, even though it is a scientifically established fact that dependence generally involves several relapses. And drug courts often actively deny substitutions therapies despite their proven effectiveness in managing dependence. Is this how we treat people with a heart condition or other health condition and who fail to follow the doctor’s orders for better health?

Worse still is the growing tendency to prosecute close acquaintances of overdose victims for homicide, though they may have merely consumed with them or arranged a purchase. This only prevents people from seeking medical help when needed for fear of the law, further increasing the number of deaths due to overdose. This is true for any service that may save lives where the person seeking them risks being treated as a criminal.

Saving lives must be the paramount argument for any approach to drug control policy, since we can only help someone who stays alive. This cannot be done when consumption and possession for personal use are criminalized.

Decriminalization is supported by a number of prominent voices, including health scientists, economists, and the media. This approach has been implemented in several countries around the world, and has been adopted or is being debated in some form or another in the US at the local level. Last year, for instance, Oregon “de-felonized” the possession of drugs for personal use, treating it now as a misdemeanor, following other experiments in California, Washington and New Mexico with law-enforcement diversion programs.

Finally, although all the technical tools we listed above exist to address this overdose crisis and are well known, any effective response depends on political will and the vision of the society we wish to build. The epidemic has shown how a model of prohibition, chosen by few and imposed through repressive policies, is responsible for more harms than those caused directly by the substances. Health, reliable information, and evidence must constitute the cornerstone of drug policy to end this unprecedented public challenge.

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The purpose of The Global Commission on Drug Policy is to bring to the international level an informed, science-based discussion about humane and effective ways to reduce the harm caused by drugs and drug control policies to people and societies.

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